Background. The advantages of a laparoscopic approach for the treatment of gastric cancer have already been demonstrated in Eastern Countries. This review and meta-analysis aims to merge all the western studies comparing laparoscopic (LG) versus open gastrectomies (OG) to provide pooled results and higher levels of evidence. Methods. A systematic literature search was performed in MEDLINE(PubMed), Embase, WebOfScience and Scopus for studies comparing laparoscopic versus open gastrectomy in western centers from 1980 to 2021. Results. After screening 355 articles, 34 articles with a total of 24,098 patients undergoing LG (5445) or OG (18,653) in western centers were included. Compared to open gastrectomy, laparoscopic gastrectomy has a significantly longer operation time (WMD = 47.46 min; 95% CI = 31.83–63.09; p < 0.001), lower blood loss (WMD = −129.32 mL; 95% CI = −188.11 to −70.53; p < 0.0001), lower analgesic requirement (WMD = −1.824 days; 95% CI = −2.314 to −1.334; p < 0.0001), faster time to first oral intake (WMD = −1.501 days; 95% CI = −2.571 to −0.431; p = 0.0060), shorter hospital stay (WMD = −2.335; 95% CI = −3.061 to −1.609; p < 0.0001), lower mortality (logOR = −0.261; 95% the −0.446 to −0.076; p = 0.0056) and a better 3-year overall survival (logHR 0.245; 95% CI= 0.016–0.474; p = 0.0360). A slight significant difference in favor of laparoscopic gastrectomy was noted for the incidence of postoperative complications (logOR = −0.202; 95% CI = −0.403 to −0.000 the = 0.0499). No statistical difference was noted based on the number of harvested lymph nodes, the rate of major postoperative complication and 5-year overall survival. Conclusions. In Western centers, laparoscopic gastrectomy has better short-term and equivalent long-term outcomes compared with the open approach, but more high-quality studies on long-term outcomes are required.

Objective: The use of a hyaluronic acid-based product has the potential to improve the hydration status of the mucous membranes, especially in the oral cavity. This study has evaluated the in vivo adhesiveness of a product based on hyaluronic acid combined with xanthan gum and carbomer to the oral cavity mucosa in human healthy subjects. The product was administered to 10 healthy volunteers during two tests: in the first participants were asked to abstain from drinking and eating for the duration of the test; in the second participants were free to follow their daily routine. In both tests, samples were taken by brushing the oral cavity immediately after administration of the product, and then after each hour, up to 4 hours. A qualitative and quantitative analysis of the drug was carried out by observation of the samples stained with Alcian Blue at pH 2.5. Results: In both tests the analysis demonstrated the presence of the product in all collected samples, up to 4 hours after administration of the product, confirming that the combination of hyaluronic acid with xanthan gum and carbomer can provide a long-lasting, durable mucoadhesive hydrogel.Keywords: Adhesiveness, carbomer, hyaluronic acid, oral cavity mucosa, xanthan gum.

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